Pharmacy Services

formularydownload1CenCal Health Pharmacy Services provides a comprehensive pharmacy benefit that includes formulary management, a robust pharmacy network, and quality customer service. Our pharmacy network spans both Santa Barbara and San Luis Obispo Counties providing our members with convenient pharmacy locations.

Pharmacy Benefit Manager

CenCal Health has contracted with MedImpact as its Pharmacy Benefit Manager (PBM) to assist in the administration of our pharmacy benefit.

medimpact

epocrates2MedImpact provides: 

  • Claims processing
  • Pharmacy network management
  • Prior authorizations
  • Customer service
  • Drug utilization management services

formsdownloadCenCal Health Pharmacy Team shall oversee MedImpact’s administrative and daily operational role. To contact MedImpact, call: (800) 788-2949.


Our Promise: Our Pharmacy Team is committed to providing consistent, compassionate, local support.

pharmacy news

Prepare for 2016-2017 Flu Season

The Flu Season is now upon us. The Pharmacy Flu Program can help your patients stay healthy this flu season. As part of the pharmacy benefits provided by CenCal Health and MedImpact, our members are eligible to receive the flu vaccine directly from a participating pharmacy in our network. CenCal Health members may choose from a variety of participating pharmacy locations including drug stores, supermarkets, retailers and independent pharmacies. Members may contact their local pharmacy for vaccination hours and appointment requirements. If providers chose to administer the flu vaccine in their office, they can bill CenCal Health. 

If you have questions regarding the Pharmacy Flu Program, please contact the CenCal Health Pharmacy Services Department at (800) 421-2560 ext. 1080.

Synagis® Pharmacy Update: RSV Season

CenCal Health would like to assist our members and providers in preparation for the upcoming RSV season. In conjunction with the Department of Health Care Services' Childrens' Medical Services Network, the Synagis® prophylaxis season will begin November 1, 2016, and run through March 31, 2017. Medical Request Forms (MRFs) will be accepted beginning October 1st for initial administration beginning November 1st to ensure that the infant's/child's weight is current. 

Synagis® is required to be ordered through our Specialty Pharmacy vendor, Diplomat Specialty Pharmacy. Order forms for Synagis can be found at : Synagis Form or by contacting Diplomat Specialty Pharmacy directly at (877) 319-6337. Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions or need any assistance. 

  



Formulary Updates

Formulary Updates March 2017

CenCal Health has made several changes to our Formulary based on clinical review, provider interest, cost and utilization analysis. 

All of the changes represent development and growth of our current Formulary thus giving more choices to the prescribing physician. The changes are represented in summary on the chart below.

Drug
Class Formulary Status Restriction/Limits  Implementation Date 
Formulary Additions 
atorvastatin calcium
(Lipitor)
Antihyperlipidemic
Formulary: Removed Step
Therapy/Added Quantity Restriction
Restriction:Quantity limit of 30 tablets per 30 days

3/1/2017
rosuvastatin calcium
(Crestor)
Antihyperlipidemic Formulary: Step Therapy/Quantity Restriction Restriction: 1. Single Step Therapy-Trial of Simvastatin or Atorvastatin, 90 day trial in the last 180 days. 
2. Quantity limit of 30 tablets per 30 days
3/1/2017
Norditropin  Growth Hormone Formulary: Diplomat Specialty Restriction: Preferred Growth Hormone 3/1/2017
 Formulary Changes
Omnitrope  Growth Hormone Non-Formulary Removed from Formulary 3/1/2017

specialty pharmacy

Specialty medications are processed uniquely, require special handling, and entail personalized medication management. CenCal Health has contracted exclusively with Diplomat and Accredo Specialty Pharmacy to provide specialty medications for our members. Learn more about specialty medications and review our Specialty Drug List.

diplomatlogo

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